How do expert labor nurses view their role?

OBJECTIVE: To examine how expert perinatal nurses in a nurse-managed labor model view their role in caring for mothers during labor and birth. DESIGN: Focus group methodology. Data were analyzed using inductive coding methods to gain understanding from the perspective of those providing the care. SETTING: Labor and birth units in four large Midwestern medical centers. PARTICIPANTS: Fifty-four expert labor nurses. Inclusion criteria: 5 years experience in nursing care during labor and birth in institutions where nurse-managed labor was the predominant practice model. RESULTS: Four common themes related to nursing roles were identified. These included knowing the labor process and the intuitive nature of nursing care provided by expert labor nurses based on years of experience, knowing the woman and letting her body guide labor, advocacy for laboring woman, and the autonomous nature of the nurse-managed labor model. CONCLUSIONS: Expert labor nurses developed a keen sense of intuitive knowledge based on their years of experience. They reported using hands-on high-touch supportive care techniques with the potential to affect labor and birth outcomes. Autonomy is perceived as a key component of practice within the nurse-managed labor model.     

Neural changes after Emotional Freedom Techniques treatment for chronic pain sufferers

This clinical trial investigated the effect of an Emotional Freedom Techniques (EFT) intervention on brain activation in chronic pain sufferers using functional magnetic resonance imaging (fMRI). EFT is a brief stress reduction technique which combines stating a cognitive statement with somatic tapping on acupressure points. Twenty-four adults were allocated to a six-week online group EFT treatment and underwent resting-state fMRI pre and post the intervention. A repeated measures MANOVA indicated significant differences in the levels of pain severity (−21%), pain interference (−26%), quality of life (+7%), somatic symptoms (−28%), depression (−13.5%), anxiety (−37.1%), happiness (+17%), and satisfaction with life (+8.8%) from pre-to post-test. Cohen's effect sizes ranged from small (0.2) to large (0.75) values suggesting significance for the intervention. fMRI analysis showed post-EFT treatment significantly decreased connectivity between the medial prefrontal cortex (a pain modulating area) and bilateral grey matter areas in the posterior cingulate cortex and thalamus, both areas being related to modulating and catastrophizing of pain. There were no brain areas that showed significantly increased connectivity post-EFT treatment. Coupled with the psychological measures the findings support the effects of the EFT intervention in reducing chronic pain and its impacts. Recommendations for future research are discussed.     

Counterregulation in female obese emotional eaters: Schachter, Goldman, and Gordon's (1968) test of psychosomatic theory revisited

In a sample of 31 obese women, the moderating role of restrained, emotional, and external eating (as was measured by the DEBQ) on the relationship between food deprivation and food intake was studied by examining the prediction of grams of cookies eaten by the preload and degree of restrained, external, and emotional eating interactions. In addition, the main effects of each type of eating behaviour on food intake was studied, and also whether any of the effects were attenuated when variance associated with the other types of eating behaviour was partialled out. Emotional eating was found to moderate the relationship between food intake and food deprivation, and this effect became even more pronounced when the variance associated with external eating was removed. Instead of eating less after a preload, emotional eaters ate more, suggesting a counter regulatory eating pattern of female obese emotional eaters. Further, also the main effect of emotional eating on food intake was significant. Both results suggest support for psychosomatic theory.     

Genetic variation in CYP2D6 impacts neural activation during cognitive tasks in humans

The drug metabolizing cytochrome P450 2D6 enzyme (CYP2D6) is highly expressed in brain and potentially involved in neurotransmitter biotransformation. Here, we report the effect of the CYP2D6 genotype on brain activation during a working memory and an emotional face matching task measured with fMRI.Subjects were taken from an ongoing large scale multicenter imaging genetic study. CYP2D6 genotyping of the alleles *2, *3, *4, *5, *6, *9, *10, *17, *35, *41 and the duplication was performed in N = 114 healthy drug free individuals. All individuals had completed two tasks in functional brain imaging: an n-back working memory task and an implicit emotional face matching task. Contrast images were analyzed in second-level random effects models with CYP2D6 enzyme activity levels as regressor of interest and age, sex and scanning site as covariates.In the working memory task, a significant effect of CYP2D6 genotype was found in the fusiform gyrus and the precuneus. In the emotional face matching task, an effect was detected in the cuneus. No significant activation results were found in the thalamus. A conjunction analysis confirmed a significant joint effect of the CYP2D6 association in both regions. In both tasks activation increased with increasing CYP2D6 activity.In conclusion, we confirmed a central nervous system effect of CYP2D6 activity in a large independent sample using a different imaging modality, and provide evidence that basic cognitive processes related to such as alertness may be impacted.     

优质护理用于顺产产妇第四产程产后出血的效果评价

目的探讨优质护理用于顺产产妇第四产程产后出血的效果评价。方法 2011年1月～12月我院经阴道分娩的产妇在第四产程所发生的产后出血情况,与2010年1月～12月产妇在第四产程所发生的产后出血情况进行统计对比分析。结果经优质护理服务培训后,2011年度在第四产程所发生的产后出血与2010年度相比有所下降,有显著性差异(P<0.01)。结论加强助产人员优质护理服务的培训,并加强产妇第四产程子宫收缩的观察,是预防产后出血的重要措施之一,也是提高产科质量的关键。